Historically, the term papilloma was introduced into the literature in the mid-19th century by Kramer. 1 Hopmann, 2 in 1883, specifically called attention to the occurrence of hard and soft types of papillomas, and at that time, the soft types were associated with inflammation and the hard types were regarded as true tumors. It was also noted by other observers that the epithelium preponderated in the hard variety and the stromal elements in the soft, or inflammatory, type. Kiesselbach, 3 in 1893, described a case of papilloma of the nose that eventually turned cancerous, and since that time other cases have been reported in the literature of the so-called hard type papillomas that have degenerated into cancer. Kramer and Som, 4 in a review of the literature in 1935, could find only 86 cases since 1856 of this rare type of tumor. Ringertz, 5 in 1938, described nine cases of